Cancellation Request Form
Select your centre
*
Gungahlin Leisure Centre
Canberra Olympic Pool
Stromlo Leisure Centre
Lakeside Leisure Centre
Membership/Program Type
Gym Membership
Swim School Membership
Name
*
First Name
Last Name
Email
*
example@example.com
Mobile
*
0400 000 000
Reason for wishing to leave facility
*
I'm lacking motivation at the moment
No time, too busy to continue my training
Financially unable to continue membership
Dissatisfied with the facility
Medical/Illness
Unable to participate in regular exercise, permanent illness or disability
Moving to different location
Personal reasons
GOswim - satisfied with level ability
GOswim - lack of progression
GOswim - lack of feedback
If applicable, attach proof of medical certificate
Browse Files
Cancel
of
I agree to Terms and Conditions
*
I, the undersigned do hereby request that my direct debit membership be cancelled. I understand that a notice period is required for all cancellation requests (30 days), unless specified otherwise on my contract. I understand that my membership cannot be cancelled while my account has overdue payments and I must pay all monies owing before cancellation can take effect.
Submit Request
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